Obamacare To Provide Help To Mental Health Patients
Monica Rodriguez, Los Angeles Daily News November 29, 2012
Obamacare will allow thousands of California adults to gain access to mental health services starting in 2014, according to a study released Wednesday.
The UCLA Center for Health Policy Research found that about a half-million adults in need of mental health treatment will be able to access it through various means, including Medi-Cal and the California Health Benefit Exchange.
About 1.6 million California adults reported having symptoms of severe psychological distress and had problems that interfered with their daily activities, according to the center's 2009 California Health Interview Survey.
One-third of those who took the survey, or about a half-million people, were uninsured for all or part of the year when the data was collected.
"Health care reform has the potential to dramatically increase the number of Californians who can access mental health services," said Imelda Padilla-Frausto, the study's lead author.
Where those residents currently receive care is difficult to say because of the unavailability of data, Padilla-Frausto said.
Based on anecdotal information, "many people are going without or going to community clinics that may or may not have the capacity" to provide the necessary care, she said.
The Patient Protection and Affordable Care Act of 2010, or Obamacare, aims to decrease the number of uninsured Americans and reduce the overall costs of health care.
Community clinics are overburdened with uninsured clients, but health care reform is expected to bolster community clinics and provide resources to treat at least some problems, Padilla-Frausto said.
"The upside (of health care reform) is 90 percent of those uninsured are going to have access to services," she said.
Agencies such as the Los Angeles County Department of Mental Health are preparing for an increase in clients.
Most of those seeking services will be people with less severe problems that the department hasn't been able to assist, said Marvin Southard, director of the L.A. County Department of Mental Health.
They are clients who were told they couldn't receive service from the county because their problems weren't severe enough, he said.
Now, those same people will be able to receive care early on, "which is a good thing because it gives us an opportunity to intervene before they become disabled," Southard said.
The county has started enrolling tens of thousands of mental health clients for Medi-Cal through a special waiver in preparation for the 2014 implementation of the Affordable Care Act, he said.
In addition, various programs have already started operating that are part of an effort to provide clients services.
Among the programs is placing Mental Health Department personnel in county health clinics to make it easier for people to access services and to provide a way that takes away the stigma of seeking mental health services, Southard said.
Instead of going to a location that offers mental health services, those services simply become part of a person's overall well-being, he said.
Another program involves the creation of mobile teams that go and make contact with the homeless population and make services available to them, Southard said.
Those and other programs will probably became part of of a multi-prong strategy, he said.
Each program will be used in a different part of the county based on what works best in each area, he said.
Of the half million people discussed in the study, about a third will be residents of Los Angeles County, Southard said, and about 75,000 will seek care through the Department of Mental Health.
About 30,000 of the half million will be residents of San Bernardino County, according to that county's Department of Behavioral Health.
Of those, about 3,000 will have severe problems or have the potential for severe problems, said Michael Schertell, deputy director of the department.
Of the 30,000 people, most will have mild to moderate mental health problems that will be handled through managed care health service providers on an out-patient basis, Schertell said.
Most of the more severe cases will be addressed through the Department of Behavioral Health, he said.
It's going to be important for the county to work with health care providers in order to ensure clients receive "the right level of care at the right time," said Michelle Dusick, program manager for the San Bernardino County agency.
Prevention and early intervention programs as well as other programs to address the stigma of mental health that can keep people from seeking mental health care are in place and will continue, Dusick said.
Campaigns and programs that are designed to reach minority residents are also in place, she said.
Providing mental health services before problems become severe has many benefits because it addresses a situation before some people land in a hospital emergency room seeking treatment, Schertell said.
Other organizations such as the Pomona Community Health Center are working toward offering some mental health services, said Carmen Ibarra, the center's chief executive officer.
Ibarra said many of the center's clients need some type of mental health service.
In the center's plans are starting a program, possibly within a year, that will have mental health professionals providing short-term services monitored by a physician.
Should a patient need longer term services, then the person would be connected with the appropriate provider and follow-up to make sure the patient is receiving the necessary care.